Thursday, April 24, 2014

Patients with mRCC preferred pazopanib to sunitinib

John here - I'm not surprised that any drug is preferred to Sunitinib (Sutent).  Although it kept me going for 6.5 years, the side effects are terrible.

Patients with mRCC preferred pazopanib to sunitinib

  • April 22, 2014
Patients with metastatic renal cell carcinoma preferred pazopanib over sunitinib for first-line treatment due to lower rates of adverse events and better health-related quality of life, according to results of a randomized, controlled, double blind trial.
Patient-reported outcomes may help inform treatment selection for advanced/metastatic renal cell carcinoma (mRCC), according to researchers.
Bernard Escudier, MD, head of the immunotherapy unit at Institut Gustave Roussy in France, and colleagues enrolled 114 patients with mRCC to compare the adverse events and health-related quality of life associated with pazopanib (Votrient, GlaxoSmithKline) and sunitinib (Sutent, Pfizer).
Researchers randomly assigned half of the patients to 800 mg daily pazopanib for 10 weeks, followed by a 2-week washout and then 50 mg daily sunitinib (4 weeks on, 2 weeks off and 4 weeks on) for 10 weeks. The other half of patients underwent treatment in the reverse sequence.
Patient preference for a specific treatment regimen, assessed by questionnaire at the conclusion of each treatment period, served as the primary endpoint. Reasons for the patients’ preferences, physician preference, safety and health-related quality of life served as secondary endpoints.
Results showed 70% of patients preferred pazopanib, 22% preferred sunitinib and 8% had no preference (P<.001).
Patients who preferred pazopanib cited less fatigue and better overall quality of life. A lower incidence of diarrhea was the most cited reason for sunitinibpreference.
Sixty-one percent of physicians indicated they preferred pazopanib, whereas 22% preferred sunitinib and 17% indicated no preference.
Adverse events were consistent with each drug’s known profile, Escudier and colleagues wrote. Pazopanib appeared superior to sunitinib with regard to health-related quality-of-life measures that evaluated fatigue, hand/foot soreness and mouth/throat soreness.
Marc B. Garnick
“This study also suggests that further research is needed to evaluate the relationship between adverse events as reported by physicians using the Common Terminology Criteria for Adverse Events system, health-related quality of life measures as reported using patient-reported outcome instruments, and the actual patient experience,” the researchers wrote.
In an accompanying editorial, Marc B. Garnick, MD, of Beth Israel Deaconess Medical Center at Harvard Medical School, said the study was “a good first attempt” to define such preferences but does not do so with enough certainty to allow regulatory endorsement or
“Equally important, [it] does not provide compelling enough evidence to support direct to- consumer or medical advertising that claims superiority of pazopanib over sunitinib,” Garnick wrote. “Nonetheless, despite the limitations of their study, Escudier and colleagues are to be congratulated for taking an important first step in addressing challenges in this emerging and important area of investigation.”
For more information:
Disclosure: See the study for a full list of the researchers’ relevant financial disclosures.

Friday, April 11, 2014

Cancer could be 'starved' by pills that remove copper from body | Mail Online

Cancer could be 'starved' by taking pills that remove copper from the body, say scientists

  • Increase in copper molecules in blood can cause cancer cells to 'breathe', causing higher growth rates
  • A high level of copper could mean an increase in deadly cancers 
  • Scientist believe that pills to reduce copper could 'starve' the cancer cells
Pills that reduce the amount of copper could remove cancer from the body by 'starving' the cancerous cells.
New research by Duke University in North Carolina says too much copper in the blood, a condition caused sometimes by an excess of green vegetables and seafood, has been linked with melanoma, as well as breast, lung and thyroid cancer. 
While scientists do not believe copper causes cancer, they do believe it helps the cancer cells 'breathe' and that by removing copper we might lessen the development of cancer in the body.
A high level of copper could mean an increase in deadly cancers like melanoma (pictured)
A high level of copper could mean an increase in deadly cancers like melanoma (pictured)
Previous research has shown copper in drinking water - given at maximum levels permitted in public supplies - quickened the growth of tumours in mice.
On the other hand reducing copper levels slowed tumour growth, which suggests that copper is an essential factor in cancer in humans.
The new study has shown copper levels could play a part in forms of the disease that possess a common mutation in a cancer-causing gene called BRAF.
Experiments on mice and in cells reveal the metal is required for the growth and signalling in these tumours.
The study may allow scientists to tackle cancer with drugs used to block copper absorption in patients suffering from the rare mutation.
An increase in copper molecules in the blood (pictured) can cause cancer cells to 'breathe' more, causing higher growth rates
An increase in copper molecules in the blood (pictured) can cause cancer cells to 'breathe' more, causing higher growth rates
Similar results were achieved with drugs used to treat patients with Wilson disease, a genetic disorder in which copper builds up in body tissues and damages the brain and liver.
Professor Christopher Counter said: 'BRAF-positive cancers like melanoma almost hunger for copper.'
The BRAF gene is involved in regulating cell division and differentiation. When mutated it causes cells to go out of control.
Prof Counter and colleagues found when they blocked copper uptake by tumours with the BRAF mutation they stopped developing.
This even happened in cells resistant to treatment with compounds targeting the BRAF mutation.
Dr Donita Brady, who led the study, said: 'Oral drugs used to lower copper levels in Wilson disease could be repurposed to treat BRAF-driven cancers like melanoma - or perhaps even others like thyroid or lung cancer.'
A clinical trial has already been approved at Duke to test the copper-reducing drugs in patients with melanoma.
Prof Counter said: 'This is a great example of how basic research moves from the laboratory to the clinic.'